Posterior assisted levitation (PAL) by using Akahoshi/Wahab irrigating pars plana levitator

To assess the outcome of irrigating Akahoshi/Wahab pars plana levitator for posterior assisted levitation in dropped nucleus during phacoemulsification.

A case series.

Ophthalmology Unit-III, Dow University of Health Sciences at Sindh Government Lyari General Hospital and Al-Noor Eye Hospital, Karachi, from January 2008 to December 2009.

Cases of dropped nucleus during phacoemulsification were recruited. Predisposing factors and stage of phacoemulsification at which dropped nucleus were recognized. Levitator was inserted through pars plana after vitrectomy around nucleus and levitation was carried out. Follow-up was done till 6 months.

Thirty two patients including 18 males (56.3%) and 14 females (43.8%) underwent pars plana levitation. Predisposing factors were pupillary miosis in 9 cases, Brunescent cataract in 7 cases, pseudoexfoliation in another 7 cases, hypermature cataract in 5 cases and extended capsulorrhexis in 4 cases. Posterior capsular rent occurred in 22 (68.8%) cases while zonular dehiscence / rupture were found in 10 cases (31.3%). Nuclei were dropped during quadrant aspiration in 10 cases (31.3%) and during chopping in 8 cases (25%). Another 5 cases (15.6%) occurred during each hydrodissection and chopping while 4 cases (12.5%) were found during sculpting of nuclei. Final best corrected visual acuity was 6/12 and better in 22 cases (68.8%) while in 10 cases (31.3%) it was 6/18 to 6/36. No complication related to pars plana levitator was observed.

Posterior assisted levitation of dropped nucleus during phacoemulsification by irrigating Akahoshi/Wahab pars plana levitator is a fast and safe surgical technique.